Lyme Disease Neuroretinitis: A Case Report and Review of Immunologic Workup

Abstract

Background: Lyme disease is an infection caused by a bacterial spirochete of the borrelia genus. The human vector is from a tick bite by an infected tick of the ixodes genus, commonly referred to as the deer tick or black legged tick. The incidence of Lyme disease is increasing in the United States. Once infected, Lyme disease manifestations usually depend on the stage of infection with late stage infection often causing debilitating illness.1 Case Report: Neuroborreliosis refers to borrelia, causing neurological infection and can occur as acute or late manifestation of Lyme disease. Neuroretinitis is a rare but reported manifestation of neuroborreliosis. Lyme diagnosis requires a two-step serologic test to meet CDC guidelines for Lyme confirmation.1 Testing may be negative early in disease but may turn positive as the disease progresses. Conclusion: Presented is a case where treatment decisions were made based on equivocal Lyme testing results.